Transmission dynamics of the etiological agent of SARS in Hong Kong: Impact of public health interventions

Steven Riley, Christophe Fraser, Christl A. Donnelly, Azra C. Ghani, Laith J. Abu-Raddad, Anthony J. Hedley, Gabriel M. Leung, Lai Ming Ho, Tai Hing Lam, Thuan Q. Thach, Patsy Chau, King Pan Chan, Su Vui Lo, Pak Yin Leung, Thomas Tsang, William Ho, Koon Hung Lee, Edith M.C. Lau, Neil M. Ferguson, Roy M. Anderson

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Abstract

We present an analysis of the first 10 weeks of the severe acute respiratory syndrome (SARS) epidemic in Hong Kong. The epidemic to date has been characterized by two large clusters - initiated by two separate "super-spread" events (SSEs) - and by ongoing community transmission. By fitting a stochastic model to data on 1512 cases, including these clusters, we show that the etiological agent of SARS is moderately transmissible. Excluding SSES, we estimate that 2.7 secondary infections were generated per case on average at the start of the epidemic, with a substantial contribution from hospital transmission. Transmission rates fell during the epidemic, primarily as a result of reductions in population contact rates and improved hospital infection control, but also because of more rapid hospital attendance by symptomatic individuals. As a result, the epidemic is now in decline, although continued vigilance is necessary for this to be maintained. Restrictions on longer range population movement are shown to be a potentially useful additional control measure in some contexts. We estimate that most currently infected persons are now hospitalized, which highlights the importance of control of nosocomial transmission.

Original languageEnglish
Pages (from-to)1961-1966
Number of pages6
JournalScience
Volume300
Issue number5627
DOIs
Publication statusPublished - 20 Jun 2003

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Riley, S., Fraser, C., Donnelly, C. A., Ghani, A. C., Abu-Raddad, L. J., Hedley, A. J., Leung, G. M., Ho, L. M., Lam, T. H., Thach, T. Q., Chau, P., Chan, K. P., Lo, S. V., Leung, P. Y., Tsang, T., Ho, W., Lee, K. H., Lau, E. M. C., Ferguson, N. M., & Anderson, R. M. (2003). Transmission dynamics of the etiological agent of SARS in Hong Kong: Impact of public health interventions. Science, 300(5627), 1961-1966. https://doi.org/10.1126/science.1086478